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Assessment of spontaneous pneumothorax in adults in a tertiary care hospital

机译：三级保健医院成人自发性气胸的评估

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Context:Pneumothorax continues to be a major cause of morbidity and mortality among respiratory patients, but there is a paucity of data regarding etiology, clinical profile, management, and outcome of spontaneous pneumothorax (SP), from this part of the world.Aims:To assess the patients of spontaneous pneumothorax in adults with special reference to the etiology, clinical presentation, management, and outcome of SP.Settings and Design:Prospective, observational study conducted in a tertiary care institution over a period of one year.Materials and Methods:All adult patients of SP attending the department of pulmonary medicine in a tertiary hospital were studied and detailed clinical, radiological, and management data were recorded and analyzed.Results:Sixty consecutive patients, who satisfied the inclusion criteria were included in the study. Among them 10 had primary spontaneous pneumothorax (PSP) and 50 had secondary spontaneous pneumothorax (SSP). The overall male to female ratio was 4:1. The mean age of the PSP patients was 26.3 ± 2.19 years, whereas, that of the SSP patients was 53.42 ± 2.07 years (P < 0.0001). Seventy percent of the patients were smokers. The most common clinical manifestation of PSP was chest pain (80%) in contrast to dyspnea in SSP (96%). The most common cause of SSP (42%) was found to be chronic obstructive pulmonary disease (COPD) followed by pulmonary tuberculosis (30%). The cases were managed with intercostal tube drainage (85%), simple aspiration (8.33%), and observation (6.67%). Full expansion of the lung was noted in 91.67% of the cases.Conclusion:Spontaneous pneumothorax was more common in men. SSP was far more common in this study, and the predominant underlying cause of SSP was COPD, which surpassed tuberculosis as the leading cause of SSP. This is in contrast to the results from previous studies done in our country. Intercostal tube drainage was the mainstay of treatment and the response was good.
机译：背景：气胸仍然是呼吸道疾病患者发病和死亡的主要原因，但在世界各地，关于病因，临床概况，治疗和自发性气胸（SP）结果的数据很少。为了评估成人自发性气胸患者，特别参考SP的病因，临床表现，治疗和结局设置与设计：在三级医疗机构中进行的为期一年的前瞻性观察性研究。材料和方法：对三级医院肺科就诊的所有成年SP患者进行了研究，并记录并分析了详细的临床，放射学和管理数据。结果：连续纳入了60例符合纳入标准的患者。其中10例为原发性自发性气胸（PSP），50例为继发性自发性气胸（SSP）。男女总比例为4：1。 PSP患者的平均年龄为26.3±2.19岁，而SSP患者的平均年龄为53.42±2.07岁（P <0.0001）。百分之七十的患者是吸烟者。 PSP最常见的临床表现是胸痛（80％），而SSP呼吸困难（96％）。发现SSP最常见的原因（42％）是慢性阻塞性肺疾病（COPD），其次是肺结核（30％）。病例行肋间插管引流（85％），单纯抽吸（8.33％）和观察（6.67％）。结论：91.67％的患者肺部完全扩张。结论：自发性气胸在男性中更为常见。在本研究中，SSP更为常见，其最主要的潜在病因是COPD，它超过了结核病成为SSP的主要原因。这与我国以前的研究结果相反。肋间管引流是治疗的主要手段，反应良好。

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